Home Health Leaders: MedPAC’s Call For Cuts Will Kill Medicare Benefits

Home health care leaders are again vying for Medicare beneficiaries and industry workers, following suggestions that the Centers for Medicare and Medicaid Services (CMS) further cut funding and keep the “burdensome” face-to-face narrative requirement.

The Partnership for Quality Home Healthcare expressed disappointment in the Medicare Payment Advisory Commission’s (MedPAC) letter to CMS, which called for the cuts and retention of the narrative component, which CMS proposes to eliminate.

The home health care industry has already absorbed a 14% cut starting in 2014, and any additional funding cuts stand to jeopardize seniors and jobs. On Jan. 1, CMS began implementing an annual cut of 3.5% for 2014-17 — the maximum allowable under the Affordable Care Act (ACA).

CMS has previously stated that the cuts will leave “approximately 40%” of home health providers operating at a net loss by 2017, putting at risk 1.3 million seniors and nearly 465,000 home health care jobs, according to Avalere Health estimates. Additional cuts could push home health agencies to the breaking point, as they already operate on razor-thin all-payer operating margins, home health leaders say.

“Home health patients are already at risk of losing access to critical home health services due to the cuts imposed in 2014,” said Eric Berger, CEO of the Partnership for Quality Home Healthcare, in a statement. “MedPAC’s suggestion to further reduce payments beyond CMS’ current proposal would create real vulnerabilities for homebound seniors, health care professionals, small businesses and the Medicare program as a whole.”

Instead of funding cuts, the Partnership supports legislation that calls for post-acute care bundling and the establishment of value-based purchasing programs. Two such pieces of legislation include “The Bundling and Coordinating Post Acute Care ACT” (BACPAC) and the “Securing Access Via Excellence” (SAVE).

The former would establish bundled payments for post-acute care services and use post-acute care coordinators and their networks of providers to manage patient care using a 90-day, site-neutral bundled payment initiated on the day of patient discharge from the hospital.

The latter would establish a value-based purchasing program that would reduce hospital readmissions via incentives that reward positive outcomes.

To aid in program reform, the Partnership has put together the “Skilled Home Health Integrity and Program Savings” (SHHIPS) proposal, which would prevent payment of aberrant claims, strengthen the claims review processes, improve participation standards and establish temporary entry limitations to prevent excess growth.

“The skilled home healthcare community supports reform that achieves savings through targeted program integrity and value-improvement reforms – not further indiscriminate across-the-board cuts,” added Berger. “Home healthcare plays a vital role in the delivery of post-acute care for our nation’s seniors and additional funding cuts to an already strained program would do little but threaten care for millions of vulnerable seniors.”

Written by Emily Study